Effects of an Occupational Therapy Program on Functional Outcomes in Older Stroke Patients

Abstract

Background: During the last decade, occupational therapy has gained increasing importance as component of the rehabilitation programs in disabled patients. Objective: To evaluate the efficacy of occupational therapy programs in patients with a recent stroke. Methods: We selected all patients with a primary diagnosis of ischemic stroke (n = 50) consecutively admitted to the two post-acute Geriatric Rehabilitation Units (CEMI 2 and 3) of the ‘A. Gemelli’ Hospital – Catholic University of Sacred Heart, Rome, Italy. Patients in the unit CEMI 3 (intervention group) received 8 weeks (3 h per day) of a combined rehabilitation program based on occupational therapy and physiotherapy. Patients admitted to the control unit (CEMI 2) received no input from the occupational therapist. Results: Overall, patients had a moderate-to-severe impairment in basic activities of daily living; the mean ADL score was 30.8 (SD ± 7.8) in the intervention group and 30.7 (SD ± 6.1) in the control group (p = 0.9). After 8 weeks of treatment the mean ADL score in the intervention group was 13.2 (SD ± 9.9) compared to 20.3 (SD ± 11.5) in the control group (p = 0.02). Differences between the intervention and control groups were statistically significant for transfers (+2.8 vs. +1.6 points on the ADL scale, p = 0.006), locomotion (+3.4 vs. +1.7 points on the ADL scale, p = 0.01), dressing (+3.0 vs. +1.8 points on the ADL scale, p = 0.01) and self-care (+3.4 vs. +1.8 points on the ADL scale, p = 0.005). Conclusion: Our results show that patients with stroke who received occupational therapy had a greater level of independence in activities of daily living over a period of 8 weeks than patients who did not.

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

“…463 Teasell and colleagues 464 reported that even severely impaired individuals can make gains in ADL performance with extended rehabilitation designed for their tolerance levels; unfortunately, such extended rehabilitation is not typically provided in the US healthcare system. Collectively, the evidence suggests that ADL and IADL training results in greater ADL and IADL independence than no ADL or IADL training [167][168][169][170][171] (but see Logan et al 465 ). Furthermore, Liu and colleagues 466 reported that training stroke patients to mentally rehearse ADL sequences and related problem solving resulted in even greater ADL gains than ADL training alone.…”

Effectiveness Of Combined Rehabilitation Intervention For Upper Limb Function In Chronic Stroke

“…Occupational therapy is dominant in assisting people to engage in daily life activities and is an integral part of comprehensive rehabilitation (Landi et al, 2006).…”

Terapia ocupacional nos contextos hospitalares: possibilidades e desafios da residência multiprofissional

“…Em um estudo randomizado sobre a efetividade da intervenção, Graff et al (2006) concluem que a Terapia Ocupacional melhora a funcionalidade diária do paciente com demência, além de reduzir a sobrecarga do cuidador. Já para pacientes com sequela de acidente vascular encefálico, estudos de Steultjens et al (2003) e Landi et al (2006) concluem que os pacientes atendidos pelos terapeutas ocupacionais apresentam maiores níveis de independência em atividades de vida diária. resgate e/ou descoberta de atividades significativas, reabilitação cognitiva, adequação do ambiente e do funcionamento domiciliar, orientação aos familiares e cuidadores.…”